I was called into the hospital to deliver a pump to a mom whose baby was not
latching on after 3 days of effort. The neonatologist asked if I could visit
with the mom, and seemed resigned that breastfeeding wasn't going to happen.
Once I got there, the nurse caring for the baby mentioned to me a suspicion
of tongue-tie. One look, and yup; there it was. They said baby had not been
latching on, though he finally did right before I got there. However, they
described short, choppy sucks and a struggle to pull the breast in or
extract milk. I didn't get to see baby try to feed because he was all tanked
up, but I did check the oral cavity and palpate the frenulum; tongue was
bunched in back, almost squared in front, and frenulum thin and tight. Seems
pretty clear cut, right?
So I explained how we try to help baby breastfeed, but that if it continues
to be a struggle, then a clipping might be appropriate. Mom's peds practice
does NOT believe in this, but I figured we'd take it one step at a time. On
the way out I mentioned what I saw to the neonatologist, who seemed rather
negative. She said she had "checked around," to where I'm not sure; someone
said, "you aren't doing THOSE there, are you?" She also said she checked
the AAP and that they considered clipping to be CONTRAINDICATED. Needless to
say, she wasn't impressed with my assessment.
Ok, is this true? I just went to the AAP website and a search came up with
nothing. Does the Academy of Breastfeeding Medicine have a statement on
this? How can I counter this neonatologist's concern that the AAP thinks
that frenotomy is risky and unnecessary, and therefore the risks outweigh
the benefits?
Don't all jump on me here; I know that sounds silly, but these people are
not coming from where we are at and they don't see the whole picture very
accurately. I need to start by dealing with this AAP thing, and I'd
appreciate any help I can get.
Thanks,
Lisa Marasco
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